PMID- 37633868
OWN - NLM
STAT- MEDLINE
DCOM- 20230912
LR  - 20230922
IS  - 1481-8043 (Electronic)
IS  - 1481-8035 (Linking)
VI  - 25
IP  - 9
DP  - 2023 Sep
TI  - Referral pathways for chronic pain patients from Canadian emergency departments: 
      emergency physicians' practices, perspectives, and recommendations.
PG  - 761-767
LID - 10.1007/s43678-023-00566-3 [doi]
AB  - BACKGROUND: Patients with chronic pain account for 12-20% of total emergency 
      department (ED) and was the primary presenting concern among 37% of patients who 
      visited the ED > 12 times per year. Despite this, emergency physicians receive 
      little focused training managing these patients, and there is a paucity of 
      effective referral pathways from EDs, despite strong evidence that chronic pain 
      is best treated longitudinally in multidisciplinary clinics. This study sought to 
      explore the practices, perspectives, and recommendations of current Canadians 
      emergency physicians in better serving the chronic pain patient (CPP) population 
      in the ED. METHODS: An electronic cross-sectional survey was administered to 
      members of the Canadian Association of Emergency Physicians (CAEP), consisting of 
      16 multiple choice and numerical response questions. Responses were summarized 
      descriptively as percentages and as the median and inter-quartile range (IQR) for 
      quantitative variables. RESULTS: The study was completed by 169/1635 respondents 
      for a response rate of 10%. The most common presentations respondents saw were 
      neuropathic pain and centrally mediated disorders (23% each) and low back pain 
      (19%). 86% of respondents felt that chronic pain patients did not get appropriate 
      referrals from the ED, and 70% of respondents were unaware of where they could 
      even refer chronic pain patients from the ED. 96% of respondents felt that their 
      ED did not have an effective referral pathway for chronic pain patients. Rapid 
      access clinics for common conditions, reduced pain clinic wait times, and clear 
      ED referral pathways were the commonest recommendations by respondents. 
      CONCLUSION: There is a clear need to increase the accessibility to outpatient 
      pain medicine clinics for chronic pain patients presenting to the ED. ED and pain 
      medicine providers must collaborate to establish mutually beneficial referral 
      pathways from EDs, and to advocate for increased funding for rapid access 
      outpatient pain clinics.
CI  - (c) 2023. The Author(s), under exclusive licence to Canadian Association of 
      Emergency Physicians (CAEP)/ Association Canadienne de Medecine d'Urgence (ACMU).
FAU - Grant, Kiran L
AU  - Grant KL
AUID- ORCID: 0000-0003-0564-4932
AD  - Department of Emergency Medicine, University of British Columbia, Vancouver, BC, 
      Canada. Kiran.grant@mail.utoronto.ca.
FAU - McParland, Aidan L
AU  - McParland AL
AD  - Department of Emergency Medicine, University of British Columbia, Vancouver, BC, 
      Canada.
FAU - Francispragasam, Mario
AU  - Francispragasam M
AD  - Department of Emergency Medicine, University of British Columbia, Vancouver, BC, 
      Canada.
AD  - Department of Anesthesiology, Pharmacology and Therapeutics, University of 
      British Columbia, Vancouver, BC, Canada.
FAU - Oxciano, Patrick
AU  - Oxciano P
AD  - Department of Emergency Medicine, University of British Columbia, Vancouver, BC, 
      Canada.
AD  - Department of Anesthesiology, Pharmacology and Therapeutics, University of 
      British Columbia, Vancouver, BC, Canada.
LA  - eng
PT  - Journal Article
DEP - 20230826
PL  - England
TA  - CJEM
JT  - CJEM
JID - 100893237
SB  - IM
MH  - Humans
MH  - *Chronic Pain/therapy
MH  - Cross-Sectional Studies
MH  - Canada
MH  - Outpatients
MH  - Emergency Service, Hospital
MH  - Referral and Consultation
MH  - *Physicians
OTO - NOTNLM
OT  - Chronic pain
OT  - Referral pathways
OT  - Vulnerable populations
EDAT- 2023/08/27 05:43
MHDA- 2023/09/12 06:41
CRDT- 2023/08/26 23:04
PHST- 2023/03/30 00:00 [received]
PHST- 2023/07/23 00:00 [accepted]
PHST- 2023/09/12 06:41 [medline]
PHST- 2023/08/27 05:43 [pubmed]
PHST- 2023/08/26 23:04 [entrez]
AID - 10.1007/s43678-023-00566-3 [pii]
AID - 10.1007/s43678-023-00566-3 [doi]
PST - ppublish
SO  - CJEM. 2023 Sep;25(9):761-767. doi: 10.1007/s43678-023-00566-3. Epub 2023 Aug 26.